PARK DUVALLE COMMUNITY HEALTH CENTER, INC (NPI# 1811545403) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811545403 |
| Entity Type | Organization |
| Organization Name | PARK DUVALLE COMMUNITY HEALTH CENTER, INC |
| Practice Address |
5901 Greenwood Rd Louisville KY 40258-2409 |
| Mailing Address |
3015 Wilson Ave Louisville KY 40211-1969 |
| Practice Telephone | 5027744401 |
| Mailing Telephone | 5027744401 |
| Enumeration Date | 2019-08-28 |
| Last Update Date | 2019-08-28 |
| Authorized Official Name | ELIZABETH HAGAN GRIGSBY (CEO) |
| Authorized Official Telephone | 5027744401 |
| Is Organization Subpart | Y |
| Parent Organization Name | PARK DUVALLE COMMUNITY HEALTH CENTER, INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Park Duvalle at Pleasure Ridge Park Health Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780698506 | Park Duvalle Community Health Center, Inc | Clinic/Center | 2237 Hikes Ln, Louisville, KY 40218-2203 | 2006-07-28 |
| 1275151292 | Park Duvalle Community Health Center, Inc | Clinic/Center | 3015 Wilson Ave, Louisville, KY 40211-1969 | 2020-07-07 |
| 1639727951 | Park Duvalle Community Health Center, Inc | Clinic/Center | 1130 W Chestnut St, Louisville, KY 40203-2047 | 2019-08-29 |
| 1851957252 | Park Duvalle Community Health Center, Inc | Clinic/Center | 75 Park Rd, Wing #1, New Castle, KY 40050-3095 | 2019-05-13 |
| 1518184613 | Park Duvalle Community Health Center, Inc | Pharmacy | 3015 Wilson Ave, Louisville, KY 40211-1969 | 2007-04-19 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | PARK DUVALLE COMMUNITY HEALTH CENTER, INC. | 3015 Wilson Ave, Louisville, KY 40211-1969 |
| Street Address |
5901 GREENWOOD RD |
| City | LOUISVILLE |
| State | KY |
| Zip Code | 40258-2409 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992226351 | Olivia Justine Stivers | Nurse Practitioner | 5901 Greenwood Rd, Louisville, KY 40258-2409 | 2017-07-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912519810 | Natalie Calhoun | Nursing Care | 6706 Wyckoff Court, Louisville, KY 40258 | 2020-08-20 |
| 1710597075 | Breanna Albright | Nurse Practitioner | 8594 Dixie Highway, Lou, KY 40258 | 2020-08-03 |
| 1528548831 | Assocaites In Pediatric Therapy LLC | Physical Therapist | 3110 Creek Drive, Lousiville, KY 40258 | 2018-08-16 |
| 1972097277 | D & D Dental Enterprises | Clinic/Center | 6790 Dixie Hwy, Louisville, KY 40258 | 2018-06-20 |
| 1295259695 | Antonio Lavelle Booker | Pharmacist | 7500 Terry Road, Louisville, KY 40258 | 2017-07-28 |
| 1568880037 | All About Your Hair LLC | Specialist | 7828 Westbrook Rd, Louisville, KY 40258 | 2014-04-02 |
| 1700215019 | Anna Solce | Pharmacist | 7338 Dixie Highway, Louisville, KY 40258 | 2013-11-06 |
| 1427147206 | Eric A. Burnett | Internal Medicine | 8019 Dixie Hwy Suite101, Jencare Neighborhood Medical Center Valley Station LLC, Louisville, KY 40258 | 2006-10-12 |
| 1861585531 | Amy B. Farnsworth | Dentist | 7206 Dixie Hwy., Louisville, KY 40258 | 2006-10-02 |
| 1720096951 | Endodontic Associates of Louisville Pllc | Dentist | 7214 Dixie Hwy, Louisville, KY 40258 | 2006-08-03 |
| Find all providers in zip 40258 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649732603 | Family Health Centers, Inc. | Clinic/Center | 4803 Southside Dr, Louisville, KY 40214-2111 | 2019-04-01 |
| 1578774477 | Family Health Centers, Inc. | Clinic/Center | 4805 Southside Dr, Louisville, KY 40214-2111 | 2007-05-24 |
| 1770680019 | Greater Meridian Health Clinic, Inc. | Clinic/Center | 14130 Highway 15 S Ste D, Louisville, MS 39339-6452 | 2006-09-20 |
| 1780698506 | Park Duvalle Community Health Center, Inc | Clinic/Center | 2237 Hikes Ln, Louisville, KY 40218-2203 | 2006-07-28 |
| 1255354361 | Park Duvalle Community Health Center, Inc. | Clinic/Center | 1015 W Chestnut St, Louisville, KY 40203-2048 | 2006-07-26 |
| 1275151292 | Park Duvalle Community Health Center, Inc | Clinic/Center | 3015 Wilson Ave, Louisville, KY 40211-1969 | 2020-07-07 |
| 1639727951 | Park Duvalle Community Health Center, Inc | Clinic/Center | 1130 W Chestnut St, Louisville, KY 40203-2047 | 2019-08-29 |
| 1427574862 | Family Health Centers, Inc. | Clinic/Center | 2500 W Market St, Louisville, KY 40212-1541 | 2017-08-17 |
| 1245253160 | Park Duvalle Community Health Center, Inc. | Clinic/Center | 3015 Wilson Ave, Louisville, KY 40211-1969 | 2006-07-25 |
| 1134172489 | Family Health Centers, Inc. | Clinic/Center | 834 E Broadway, Louisville, KY 40204-1072 | 2006-05-18 |
| Find all providers in LOUISVILLE | ||||
| City | LOUISVILLE |
| Zip Code | 40258 |
Please comment or provide details below to improve the information on PARK DUVALLE COMMUNITY HEALTH CENTER, INC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.